The neurological examination is accomplished by examining in succession, the higher functions by testing memory, intelligence, orientation in time, place and person, and speech, the cranial nerves, the motor and sensory systems, cerebellar functions and the reflexes. In practice, those skilled in the art of testing the nervous system have been required to carry numerous separate testing devices. This variety of testing devices carried by the clinician is costly and cumbersome and if not done in a sequential methodology oftentimes the testing of certain sensory aspects can be missed.
The present invention is designed with the express intent of providing in one small device many of the essential ingredients for a thorough neurological examination. The device which can be carried in a lab coat pocket or shirt pocket, is made in a simple and relatively inexpensive fashion so that the device can either be used as a disposable device or as a low cost tool by the clinician.
In U.S. Pat. No. 5,233,988 a neuro-aid satisfying some of the above requirements was granted a patent on Aug. 10, 1993. This original neuro-aid device provided a portable, inexpensive tool which the clinician could use to examine a patient for neurological responses. While being an efficient device for neurological examinations it lacked several features which are considered to be essential in proper neurological examinations.
The present invention is an improved neuro-aid device which provides low cost solutions to neurological examinations while providing additional capabilities. The improved device adds features that will enable the clinician to examine the fundus (retina) and sensitivity to light as well as providing an improved aseptic method of conducting touch responses using a sterile, detachable pin system. Provisions have also been made for metric scale for measuring the size of pupil and for carrying charts and/or tables within the device.
It is currently recognized that in many athletic sports and other activities head injuries often occur. These head injuries can be rated from minor to severe. Commonly referred to as concussions or mild traumatic brain injuries (MTBI), these are the most common and least serious of this type of traumatic brain injury. These concussions involve a transient loss of mental functions that can be caused by acceleration or deceleration forces or by a direct blow. Concussions are generally not associated with penetrating head injuries. Patients with concussions may act confused for example repeatedly asking the same question or forgetting where they are. Patients may have focal neurological deficits, signs that a specific part of the brain is not working correctly. While such trauma are considered mild generally, the brain is adapted in such a way that after a mild concussion, a repeated secondary impact on the brain can lead to serious and permanent brain damage and potentially death. As a result in such sports as football, head injuries are reviewed by a trainer immediately and certain sensory responses are tested to see if the player has been injured seriously enough that he should no longer play. It is not uncommon for a player who has had a head injury to return to play within a week and upon receiving a secondary head injury, of dying. As a result many high school and college programs by state law are required to have medically trained physical trainers onsite to look for these types of head injuries. One of the best ways of indicating whether a person has received a concussion is an examination of the eyes. If the eyes show aberrant movement or one pupil is dilated more than the other or if the eyes fail to respond to light sensitivity may be strong indications that the player has had a concussion. As a result it is now normal practice to remove such players from further contact. It is accordingly very important that these trainers have tools that will enable eye reflexes to be easily examined. Checking the peripheral vision was available on the prior art device, however, this device was lacking in that light sensitivity and fundus could not be examined. Accordingly, a need to improve the device incorporating such a feature was determined necessary.
In addition, in checking an injured person's response to touch to determine if any nerve damage had occurred to any limbs or any portion of the nervous system has been essential in these neurological examinations. The prior art device of U.S. Pat. No. 5,233,988 provided an integrally molded sharp point at one end of the device which could be used to poke into the patient to determine if the sense of pain was felt in the location where the device was pushed. This exposed the person conducting the test and the subsequent patient's to the increased risk of contracting blood transmitted diseases from the person being examined. As such the entire device typically had to be thrown away. It was determined that had this touch test been one that could be provided by a removable needle or pin, the device could then be used on multiple patients without the risk of either transmitting blood-borne diseases. These and other beneficial improvements have been provided in the improved inventive device as described below.